Multiple osteotomies of the tibia and/or fibula with bone realignment stabilized on an intramedullary rod — the Sofield-type procedure for severe angular or rotational deformity correction.

Verified May 8, 2026 · 6 sources ↓

Medicare: $1,016.72
Total RVUs: 30.44
Global, days: 90
Region: Foot & ankle

Drawn from CMSNovitasAAPC

Documentation requirements

What must appear in the operative or office note to support the claim.

Source · Editorial brief grounded in 6 cited references ↓

Diagnosis establishing the underlying deformity (e.g., osteogenesis imperfecta, metabolic bone disease, post-traumatic malalignment) with ICD-10 code
Operative note naming the specific bone(s) cut — tibia, fibula, or both — and the number and levels of osteotomies performed
Description of the intramedullary rod used, including type, size, and method of fixation at each realigned segment
Imaging (preoperative X-rays or CT) documenting the angular or rotational deformity requiring multi-level correction
Surgeon's narrative explaining why multiple osteotomies were necessary rather than a single corrective cut
Intraoperative fluoroscopy records confirming alignment on the rod before wound closure

Applicable modifiers

Modifiers commonly billed with this code.

Source · AMA CPT modifier descriptors · CMS NCCI Policy Manual

22 Increased complexity 51 Multiple procedures 52 Reduced services 59 Distinct service 62 Co-surgeons 74 Discontinued post-anesthesia 78 Unplanned return — related 79 Unrelated during global 80 Assistant surgeon LT Left side RT Right side

What this code covers

Source · Editorial summary grounded in 6 cited references ↓

CPT 27712 covers a Sofield-type procedure: multiple osteotomies through the tibia (and often the fibula) with realignment of bony segments on an intramedullary rod. This is not a routine corrective osteotomy — it is reserved for patients with severe, multi-level deformity such as osteogenesis imperfecta, severe metabolic bone disease, or post-infectious or post-traumatic segmental malalignment that cannot be corrected with a single-level cut. The procedure requires internal fixation across all realigned segments, and documentation must reflect the number of osteotomy levels and the rationale for an intramedullary construct over a single-cut approach.

The 90-day global period applies. All routine post-operative visits, wound care, and implant-related follow-up through day 90 are bundled. If a distinct, unrelated procedure is performed during that window, bill with modifier 79. A return to the OR for a complication directly related to the index procedure uses modifier 78. An E&M for a new problem unrelated to the leg osteotomy during the global period requires modifier 24.

This code is on the CMS inpatient-only list for OPPS purposes — it cannot be billed in a hospital outpatient setting or ASC under Medicare. Verify prior authorization and site-of-service requirements with commercial payers before scheduling, as payment rules vary.

RVU & reimbursement

Component RVUs and Medicare national rate. Actual payment varies by GPCI locality.

Source · CMS Physician Fee Schedule, RVU26A · January 2026

Work RVU	15.47
Practice expense RVU	11.68
Malpractice RVU	3.29
Total RVU	30.44
Medicare national rate	$1,016.72
Global period	90 days

Payment by site of service

Medicare pays different rates by setting. HOPD typically pays substantially more than ASC for the same procedure.

Source · CMS OPPS Addendum B·ASC HCPCS payment rates·2026

Setting	Medicare rate (national)
Office (PFS non-facility) Procedure performed in physician's office	$1,016.72
HOPD (APC 5115) Hospital outpatient department	$13,116.76
ASC (PI J8) Ambulatory surgical center (freestanding)	$9,493.97

Common denial reasons

The recurring reasons claims for CPT 27712 get rejected.

Source · Editorial brief grounded in CMS NCCI edits, AAOS coding appeals, and cited references ↓

Operative note describes only a single osteotomy level, not matching the 'multiple' requirement of 27712
Billed in a hospital outpatient or ASC setting under Medicare — 27712 is on the inpatient-only list
Missing pre-operative imaging documentation to support medical necessity of multi-level deformity correction
Upcoded from 27705 or 27707 without adequate documentation of intramedullary rod fixation
Global period violation — routine post-op visits billed without modifier 24, 25, or 79 as appropriate

Frequently asked questions

Source · Generated from the editorial pipeline, verified against 6 cited references ↓

01Can 27712 be performed in an ASC for Medicare patients?

No. CMS classifies 27712 as inpatient-only under OPPS. It cannot be billed in a hospital outpatient department or ASC for Medicare beneficiaries. Verify commercial payer rules separately, as they are not bound by the OPPS inpatient-only list.

02What distinguishes 27712 from a single tibial osteotomy code like 27705?

27712 requires multiple osteotomy cuts with realignment across an intramedullary rod — a Sofield-type construct. A single proximal or shaft osteotomy without an IM rod goes to 27705 or 27707. The operative note must document multiple levels and rod fixation to support 27712.

03If the fibula also required osteotomies, is that separately billable?

Generally no — fibular osteotomies performed as part of the same multi-level realignment procedure on an IM rod are considered integral to 27712 and are not separately reportable. Check current NCCI PTP edits for any active column 2 edit pairing fibular osteotomy codes with 27712.

04How do you handle a return to the OR during the 90-day global for hardware failure?

If the return is directly related to the index 27712 procedure (e.g., rod migration, osteotomy nonunion at a treated level), bill the revision code with modifier 78. Modifier 79 applies only when the return procedure is unrelated to the original surgery.

05Is modifier 22 supportable for 27712, and what documentation is needed?

Yes, if operative complexity meaningfully exceeds a typical Sofield-type procedure — for example, extreme deformity requiring additional levels, significant blood loss requiring transfusion, or morbid obesity materially prolonging the procedure. The operative note must quantify the additional work and operative time, and the claim should include a cover letter. Expect payer scrutiny without it.

06Can 27712 be billed bilaterally on the same day?

Bilateral same-day procedures are reportable. For Medicare, bill 27712 twice with modifier 50 on the second line, or list it on two lines with LT and RT. Reimbursement for the second side is typically reduced to 50% of the allowable. Confirm bilateral policy with each commercial payer, as rules vary.

Sources & references

Editorial content was developed using the following public sources. Last verified May 8, 2026.

Mira AI Scribe

Mira's AI scribe captures the number of osteotomy levels, the bones involved (tibia, fibula, or both), rod type and size, and the clinical rationale for multi-level versus single-level correction directly from surgeon dictation. This prevents the most common audit flag for 27712: an operative note that documents only one cut, triggering a downcode to 27705 or a denial for insufficient medical necessity.

See how Mira captures CPT 27712 documentation